My Top 5 Things I Wish I Knew Before My CST Interview

Over the past few weeks, emails have been sent out and the next wave of prospective Core Surgical Trainees have been offered the opportunity to interview for a place on the UK Core Surgical Training (CST) programme. Whilst the interview looms from the not-so-distant future, it is important to allow oneself a moment of quiet congratulation, as landing an interview this year is an achievement in itself. This is because, with COVID causing interviews to become virtual, the portfolio station, which would ordinarily be part of the face-to-face interview, has already been “sat”. That is, the current CST applicants have had to submit their entire portfolio online prior to interview, which means their portfolio has already been assessed and deemed good enough to offer them an interview. This essentially reflects one successful station out of three (had it been the old format) so technically it could be said: one down, two to go!

Jollity aside, however, the notification that you’ve scored an interview can really turbo-charge the hypo-stress of waiting to full on stress. I certainly felt this way before my interview and accordingly studied and practised diligently to give myself the best shot of securing the training programme of my choice. Yet, on the day, there were a few elements which presented an unexpected challenge and made me rethink what I had assumed was adequate preparation.

Here are a curated selection of things I wished I had done for my own CST interview. Enjoy and utilise at your peril!

1. Use high impact statements first. The stations go surprisingly quickly so you can become disadvantaged if the timer goes and you haven’t been able to divulge the juiciest details that you’ve been saving up for wow factor. This includes your leadership speech. Start strong as you mean to go on.

2. Building on point number 1, expect to be driven down a rabbit hole by the interview panellists. There is a wild misconception that the interviewers will just sit back and let you ramble on about how you would single-handedly manage a trauma call brandishing nothing but a pinnie and pure grit. This is grossly untrue as I unwittingly discovered. During my clinical station, I mentioned the likely presence of rib fractures in trauma caused by crush injury and was immediately quizzed about the various clinical consequences of this finding. Having only really revised this in brief, all I could muster was “umm tension pneumothorax”. Not so slick. The correct answer in a nutshell was pulmonary contusions and haemothorax secondary to flail segment. Hindsight sucks but sharing this is the only way for me to achieve true catharsis so I implore you to use this information to your own advantage.

3. Use deep nasal breathing to settle your nerves (video tutorial if you’re new to this: https://youtu.be/gt93Pr0DNEQ). Alternatively, if you’ve been practising already, meditate before your interview. If you’re anything like me, the stress of the day can significantly impact your clarity of mind. And it makes sense. The sympathetic nervous system is kicking in and the last thing you want to do is utilise higher order thinking when you’re going into fight or flight mode. It’s incredibly difficult to enact on the day itself and one would argue, easier said than done, but if there was one single element that I would say I wish I had mastered, it would be this. I would also seriously avoid compounding the stress with copious amounts of caffeine. Your body is going to be in sympathetic overdrive anyway, so if you do caffeinate, do so in moderation as you may risk overshooting the mark and losing your head.

4. Try and get a bit of clinical time before your interview. This could be going into work the day before, if you’re scheduled to do so. But it doesn’t necessarily have to be that. You could simply read through some medical text/journal, listen to a medical podcast, or watch some medical videos. The choice is yours. But the idea is to prime your mind to start thinking clinically, so that when you are in the heat of the station, you can quickly work through the problems presented without wading through a brain full of treacle to try and come up with at least one sensible medical fact. Cognitive dexterity is a real asset due to the short amount of time available to perform well in the stations, so it’s well worth trying this out.

5. Finally, make it count. You are there because you have been chosen out of hundreds, if not, thousands of applicants. 50% of the work has already been achieved (maths unavailable, sorry – just trust me). The interview now serves to secure the job you want in the region of your choosing. So put away that imposter syndrome and feel the confidence surge through you, safe in the knowledge that you’re interviewing because the Royal College of Surgeons already considers you sufficiently able to obtain a place on the UK CST/ST1 programme.